[Extracorporeal lithotripsy of gallbladder calculi with piezoelectrically generated shock waves: initial experiences]

A piezoelectric lithotripter ("Piezolith 2300") was used in 24 patients for extracorporeal fragmentation of radiolucent gallbladder stones. In 19 patients with one stone and 4 patients with two stones (diameter: 0.8-3.1 cm) fragmentation to a maximal fragment size of 7 mm was achieved. One to three treatment sessions were necessary (mean 1.5). During adjuvant oral litholytic therapy with chenodeoxycholic acid and ursodeoxycholic acid (500 mg each daily up to 80 kg bodyweight and 750 mg in patients with more than 80 kg bodyweight) 4 patients came to be completely free of stones within a mean follow-up time of 15 weeks. Treatment was well tolerated by all patients, no analgesia or sedation was needed. Side effects were cutaneous petechiae in two patients, microscopic haematuria in two others and leucocyturia in another. We conclude that lithotripsy of gallbladder stones can be performed safely and effectively not only by the established underwater spark discharge type of lithotripter but also by the piezoelectric system.